Theory Practice and the Millennium

Russell Endowed Chair in Philosophy and Education publication contains two parts: the Russell Scholar Lecture entitled Theory, Practice and the MilLennium delivered on April 9, 1997, and

University of Southern Maine USM Digital Commons

1997

Theory, Practice, and the Millennium

Kathleen I MacPherson

University of Southern Maine

Follow this and additional works at: https://digitalcommons.usm.maine.edu/facbooks

Recommended Citation

MacPherson, Kathleen I Theory, Practice, and the Millennium: Walter E Russell Endowed Chair in

Philosophy University of Southern Maine, 1997

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Commons It has been accepted for inclusion in Faculty and Staff Books by an authorized administrator of USM Digital Commons For more information, please contact jessica.c.hovey@maine.edu

Table of Contents

INTRODUCTION 2 WALTER E RUSSELL LECTURE . 3 Kathleen I MacPherson, professor of nursing and ninth occupant

of the Walter E Russell Chair in Philosophy and Education

WALTER E RUSSELL CHAIR SYMPOSIUM

Moderator: Kathleen I MacPherson, professor of nursing

Julie Ellis, associate professor of electrical engineering .. 17 Michael Hillard, associate professor of economics 20 Rita Kissen, associate professor of education . .... 25 Mark Lapping, provost &

professor of public policy & management .. . .. 30 Julien Murphy, professor of philosophy . .. .. . 32 Susan Vines, associate professor of nursing ... ... 39 ACKN"O'WLEDGEMENTS 4·7

Introduction

This Walter E Russell Endowed Chair in Philosophy and Education

publication contains two parts: the Russell Scholar Lecture entitled Theory,

Practice and the MilLennium delivered on April 9, 1997, and six Faculty

papers presented ar the Russell Scholar Symposium entitled Theory and

Practice in Academia on October 8, I 997

/ L� ft!J ()

3

THEORY, PRACTICE AND THE MILLENNIUM Theory as Healing

by Kathleen I MacPherson,

professor,

College of Nursing

I saw my first patient die at Massachuserrs General Hospital (MGH), on the medical unit in the old Bullfinch building, which consisted of one huge room with curtains separating each bed and the head nurse's desk in the middle of the room As an 18-year-old nursing srudenr, I watched the old Italian man surrounded by doc­

tors, residents, and medical students sileotly "slip away" from life Biomedical

theory, with its focus on pathophysiology, is what I had been taught, bur it

was of no help in understanding the mystery of death, nor the stoic response

of doctors, nor my own inexpressible feeling of numbed pain Nursing in­

structors, drawing from medical education, had taught me ro remain objec­

tive and to keep "a stiff upper lip" while observing suffering and death

This dilemma of how to deal with death haunred me throughout nurses'

training and became acute as I worked as an R.N It frustrated me and made

me feel dishonest when nurses could not, in the l 950s and early 1960s, tell

patiems, who asked if they were dying, the truth h was a situarion which

caused dying patients who wanted co know the truth the excruciating pain of

abandonment As Tolstoy wrote in The Death of Ivan !lyich, "this lie that he

was not dying surrounding him, and existing in him, more than all else poi­

soned Ivan Ilyich's last days."!

1 began to deal with this dilemma by asking, "How can I shape an ethical,

humanistic nursing practice with dying patients?" Lacer J will return to this

question, but first I want ro examine the sources, academic and personal, of

my developing ability to answer it I could not know, ar tl1e rime, chat l had

been caught up in a sex-segregated profession with little auronomy or power

This changed in 1976 when JoAnn Ashley wrote the first hi:.tory of nursin�

from a feminist point of view: Hospitals, Patemnlism and the &lr of the Num

She raised the provocative question: "why have nurses had so little influence

on hospital management and health care delivery�" Ashley theorized that sys­

rematic oppression of the nursing profession, stemming from sexism and ex­

ploitation on the part of hospital administrators and physicians, is ro blame

This opened my eyes to the forces rhat had kept me silent in front of dying

patients who wanted to know the truth As a nurse 1 did not have control of

my practice Doctors' orders had to be obeyed even in such ethically torturous

siruarions Instead of healing, nurses and physicians created a practice that

caused iJlness The eriology for rh is invisible and silent illness was a theoretical

absence of having no way to address their patients and their own sorrow

Throughout history the concepts of theory and practice have be.en used

by men to link male ideas to male action Women have written on theory for centuries and directed their activism, yet male scholars have, with rare e xcep­rions, not deemed it necessary to credit women with these accomplishments

As a result, women's inrcJlectual contributions on theory and practice remained outside the corpus of scholarly work unci! the late 1960s Sister Elizabeth Kenny, a nurse who worked in rural Australia, is an example She developed a method of treating poliomyelitis pacienrs with hot packs and exercise in the 1930s At the same time, physicians were treating thousands of polio vicrims

by encasing their bodies in plaster casts Sister Kenny's method had far greater success in restoring motion than the crippling effects of traditional medical treatments Worldwide acclaim came to Sisrer Kenny after being ignored and criticized for years by medical experts, who thought it impossible that a nurse

in the Australian bush could develop a theory for rehabilitating polio patients under her care

Sister Kenny's case illustrates the power associated with people, mostly white men, who get credit, in medicine and other professions, for creating theory Her experience made me curious about formal definitions of cbeory and practice, so I turned to the Oxford Eugli.sh Dictiontl.ly: there 1 found defi­nitions with a complex range of meaning for both words Theory is a mental view, contemplation or speculation; or ir is a concepcion or mental scheme of something co be done; or it is a hypothesis chat has been confirmed or estab­lished While practice is w perform; or ro carry on habitually or constantly; or

to work at, or exercise the pursu.it of a profession Clearly there is a wide difference between the simplest and most complex: definitions For my pur­pose of creating indusive definitions, theory is a systematic explanation, and practice is an action As Sister Kenny's srory illustrates, theory and practice can lead to healing because together they can explain a complex problem and point toward a means for its resolution

Like bell hooks I am committed to theory and practice because of its power ro heal hooks has described nor knowing why her father, who rarely spoke co her, had cbe right ro punish her with whippings When she asked her mower why he had chis right, her mother responded that she was losing her mind and in need of more frequent punishment "I came ro theory," she says,

"because 1 was hurting-the pain within me was so intense that I could nor go

on living I came to theory desperate, wanting ro comprehend-to grasp whar was happening around me and within me Most importantly, I wanted the pain to go away I saw theory as a location for healing "3 ln The Significance of Theory Terry Eagleton normalized hook's childhood use of theory

Children make the best theorists, since they have not yet been edu­cated into accepting our routine social practices as "natural," and so insist on posing to those practices the most embarrassing general and fundamental questions, regarding them with a wondering estrange­ment which we adulrs have long forgotten Since they do not yet

grasp our social practices as int:virable, they do not se� why we might

nor do things differendy.4

bell hooks reminds us that theory is not inherently healing, liberating, or revo­

lutionary lt fulftlls this function only when we ask it to do so and direcr our

theorizing roward chis end

My own theorizing started in childhood as a practical way to try to under­

stand puzzling experiences or hurtful feelings I did nor grow up in a family

chat discussed theory, at least the academic kind That dtd not stop me from

asking endless quescions to my grandmother, my aunt, my uncle, and espe­

cially co my mother Driven back ro rhe family farm in northern Cape Breton,

Nova Scotia, by rhe great American Depression, we all lived in my grandpar­

enrs' farmhouse, which faced che Adantic and backed up againsc a spruce

for�t I was a curious child who questioned life around me When sent to rhe

henhouse near the barn co collect eggs in my basket each time I found eggs in

che nesrs l questioned everyone in sight '"Where do che eggs come from?"

"From the hens, dear" would be the standard answer "How?" I would invari­

ably ask The grownups, living in chis sexually repressed Calvinist community,

never gave me a straight answer

But my lack was not simply FacLS about sex; 1 was given no theory to make

isolated informacion undemaodable Thb was true of social i�sues as well My

relacionship with an absent father was a long scory char illustrates the need for

healing theory When my father was called back co work on the American

Great Lakes as a merchant seaman, he was away each year from March through

mid-December Finances mandated our staying on the Farm-my grandpar­

ents had no savings, but they had no mortgage eicl1er His absence was harder

for me to understand than where the hens' eggs had come from This was an

emotionally charged issue as I loved my father and could not understand why

he was not with us I asked my mother over and over, ''Why is Daddy away?"

She would only �ay he needed ro work to cake care of us By now, I had rwo

liccle brothers When a bit older, I would ask her, "did Daddy die? How would

we know if he did?" This quesrion starrled her, bur she remained in stony

silence My question must have touched her own fears and was not appreci­

ated This fear of my father dying and the pain it brought me was reacrivared

as I watched the old man die in his bed at Massachuseus General Hospital

Cape Breton Island is stunningly beautiful but historically has had great

difficulty providing jobs for irs daughters and sons Commonly, young sea­

worthy men like my father, left in search of jobs in "che Boston stares" as this

country was caJied by Cape Bretoners The 1930s found Canada still colo­

nized by Grear Britain, whid1 had lircle interest in developing Nova Scotia

Cape Breton, as an outpost of the province, was left ro fend for itself with the

single exception of a British-owned enterprise that controlled mining the rich

veins of coal running a rn.ile our under the sea

We had only serded inro our own home for a few years when my F.:unily

was forced, by fiat, to move to rhe United States (U.S.) Father's employer,

6

U.S Steel had ordered Canadian merchant seamen to live in the U.S and ro spend their earnings there-or be fired It w� a wrenching move for the entire family: loss of family members, friends, and Canada irself Both my father's work-related absence, and my longing to return ro Canada, caused me sorrow and grief as I struggled ro adapt ro living in a Boston suburb Later my father cold me that he had tried long and hard to find work in Nova Scoria, so that

he could be wich us, to no avail Only as an adult at the university could I find political and economic theories that explained why che power of corporations like U.S Steel was so strong chat ir could control employees, nor only at work but in their private lives as well

My father's story had a happy encling He learned social conflict theory from a union organizer and left his role as representative in the company union

co become vice president of the Great Lakes Masrer1 Maces and Engineers Union Lewis Coser, in The Functions ofSocial Conflict, defined it as a struggle over values and claims to scarce status, power, and resources "5 Opponenrs of social conflict theory airn to neutralize, injure, or eliminate their rivals Far from being only a negative factor which rears groups and sociery apart, Coser proposed that ir can serve positive functions such as reforming social inequal­ity and injustice rn che 1950s, Coser lamented the fact char conflict theory was being abandoned for "consensus," a common value orientation, and the

like That tendency, in my view, is alive and well over 40 years later The face

that presently only 15% of U.S workers belong ro unions, down from25% in rhe 1970s, is but one illustration of the presenr abandonment of conflict theory

My father's e.xperience shaped a fundamental belief of m.ine-rhac having theo­ries ready to draw upon in times of conflict and crisis can give one rhe strength

co fight back The death of my farher was a great loss, but by understanding that his absence when l was a child was nor his personal d10ice, but related to his work, helped me to heaJ His leadership in a union char used social conflict theory substantially ro improve the working condirions for members has been

a strong influence on my political beliefs Having his union struggles and victories as part of my family background undoubtedly influenced my deci­sion co practice as a member of theAffiliared Faculty Union of Maine (AFUM) negotiating team, 11 years after his death This experience led me to thinking more about my father and wishing I could calk about it with him [ began co undc:rsrand the complexities-including diiTerent degrees of power held by the University of Maine System's represenrarives and by AFUM negotiators­when consensus theory, not conflict theory ruled the negoriacing table Aside from sharing experiences we had with our tarhers, in some other ways, hooks's and my experiences were similar Very early we both rurned to books and later to che university for new knowledge Both of us were strongly drawn co feminist d1eodes Theories reframed our perceptions of childhood experiences chat had caused us pain and helped to reduce its intensity We borh believe in sharing autobiographical material, yet education as a psychiar­ric/menral health nurse and as a medical sociologist did nor train me to plur1ge publicly into areas of my life which were painful and problematic Patricia

7

Clough, in her book Feminist Thought: Desire, Power, and Academic Discourse,

defines what 1 am writing as weaving what has bee,o kept separate that is

academic discourse and the autObiographical account of one's own experi­

ences.G Adrienne Rich shared this view in O.fWoman Born For her, it seemed

impossible from the first to write a book of this kind without being autobio­

graphical, without often saying "I." Although Rich resisted this approach for

several momhs by doing hisrorical research and analysis, she realized later that

the heart of her book came from her willingness ro share private experience,

Rich proposed that feminist theorizing of motherhood be grounded in re­

membering-remembering women's experiences of mothering.? In her wake,

I propose that theorizing on theory and practice be grounded in our own

experiences: thus, to explore theories as healing l will retrnn to my firsr ques­

tion "How can I shape an ethical, hillnanistic nursing practice with dying

patients?"

Many books gave me new insights, bur none were as helpful as those

written by Elizabeth Kubler-Ross, a Swiss-hom psychiatrist and counselor on

death Her focus in Living with Deatb and Dying was exactly what 1 was look­

ing for: a theory based on clinical research with dying patiems.8 Research

fmdings showed rhar the majority of patients preferred their primary physi­

cian or nurse to be honest with them at the beginning of a serious illness

Patients also wanted enough time to come to grips with illness and to ask for

further derails when chey were ready ro hear them Women and men making

rhese requests added two conditions, both of which have to be fulfilled, ac­

cording to the research findings, in order for these patients co come to grips

wirh impending death,

The more important condition is that the physician or nurse should al­

ways allow for hope Kubler-Ross emphasized the importance ofknowing that

hope at the beginning of a serious illness is something rorally different from

hope ar the end of life At the beginning, a patieht's hope is always that the

diagnosis is not true After the diagnosis is verified, the hope is associated with

cure, treatment, or prolongation of life, W hen those are no longer probable,

then the patient's hope changes co something that is not associated with cure,

treatment, or prolongation of life hope for an afterlife or for children grand­

children, and friends ro remember rhem The second condition is that the

primary caretaker does nor desert the patient This means that she or he con­

tinues to care for the person as a human being, even when there is no longer a

possibilicy of cure

In an earlier book, On Death and Dying, Kubler-Ross looked for common

patterns among dying patients and theorized that most, but not all, patients

go through five stages of dying, The five stages do nor always occur in lock­

step order; sometimes there is skipping ahead, backtracking or simply omis­

sion During the first stage, wirh irs beginning awareness that the illness is

potentially terminal, the reaction is usually one of shock and deniaL Some

people need denial to the end of life and others, although they appear ro be in

denial, are really not These patients, like Ivan Ilyich, know what is going on,

bur nobody else is comfortable enough to acknowledge the rrutb By appear­ing ro deny death, they try to protecr others, Rage, anger, and criticism of everyone thinking, "why didn't this happen to someone else?'' are typical of the second stage In the third stage if people can express anguish, grief, and rage wirhour being judged, then they will proceed to bargain, often with God

or a physician, Patients often promise something, usually in exchange for pro­longation of life When they tlnish bargaining, patients often become sad and

go through the fourth stage which consists of two types of depression: reactive depression (mourning past losses) and preparatory grief (mourning future losses) The fifth and final stage has rwo distinctly different types of possible behavior On dte one hand, the patient usually has taken care of unfinished business, and hope is no longer associated with more time to live, There is a feeling of peace, serenity, and positive submission to things chat we cannot change, On the other hand, there is a feeling of defeat, bitterness, "what's the use?" or "I'm dred of fighting." This stage theory provides a map for health professionals working with the dying which can help to ease the depa.rrure from life.9

Ir is imporcanr ro specify what and how a theory can heal; Kubler-Ross's research provides an example Patients who have a terminal illness feel anxiety and fear from the moment rhey receive the diagnosis Healing is facilitated when the various stages of dying are understood and supported by caretakers, followed by open discussions on the probability of dying and death, if this is desired by the patient The process starts early and proceeds at the patient's pace Early rimjng stands in strong contrast with the more common practice

of discussing death only when it is ncar-if at all Kubler-Ross's research theo­rizes that the optimal outcome for the dying patient, in our culture, is to come

as close as possible to acceptance of death, If this is not possible, the caretaker (usually a nurse) has theoretical guidance for understanding the patient's feel­ings and behavior The patient who is sdll angry or severdy depressed, if not understood, can be isolated physically and emotionally from caretakers and family, reports Kubler-Ross Like lvan Ilyich, they feel poisoned during their final days Nurses and other caretakers can maintain contact and be there for the dying person

Nrnses, like myself, who became frustrated and angry because of forced silence, can be healed, For me, the theory validated my belief that nurses should have the right to an ethical and humane practice with terminally ill patients, This includes open com.mu.nication and caring until the end Nurses quickly embraced Kubler-Ross's work and used it in their practice It is not clear to me what impact the theory has had on the tendency of physicians to paint a more cheerful picture of the patient's condition chan is justified, and to remain si­tent on the subject of death I do recall that when Kubler-Ross came to Bangor, Maine, in rhe late 70s, the hall was packed with nurses bur they were unable to recognize a doctor in the audience There we.re two morticians, however, Gen­der and professional socialization seemed ro be at play here

Perhaps Kubler-Ross, her research, and her theory are fared to stay on the

margin of medical practice This is more likely now since managed care im­

peratives stress profits over labor-intensive efforts to comfort patients Lack of

rime for nurses to use chis theory in their practice may once again cause, for

rhe patients and themselves, pain based on rhe universal fear of death when it

is not openly discussed Like any theory, it will only work when put into

practice Kubler-Ross was the first researcher to observe, and to communicate

with the dying and then to make their voices heard Being born and raised in

Switzerland where she remembers that death was not hidden, even from chil­

dren, prepared her for her pioneering work in rhe United Stares Her practice

grounded her theory In turn, this enhanced rhe practice of nurses and other

health care providers As time passed and I became a Faculty member at USM,

my practice was less clinical, in a hands-on sense, and more theoretical Today

my pracdce, in large part, consists of disseminating knowledge through teach­

ing, researching, and wricing on older women's health with a special focus on

menopause in this practice, I hope to extend the healing work of theory

Practice as Knowledge Transfer Like dying, menopause was a stigmatized subject that, until recently, people

only whispered about It, roo, was an experience for which women had no

access to theory and therefore to undemanding Research on menopause was

almost exclusively based on biomedical theory To the best of my knowledge,

my 1981 article entitled "Menopause as Disease: The Social Construction of a

Metaphor" was the first in nursing literature to use various rheories to critique

biomedical model hegemony.lO It became clear to me that menopause, like

other biological events in women's lives, rakes on different meanings in c::Wfer­

enr cultural contexts, as well as multiple meanings within a single society I

decided to study menopause because of a major medical mistake that deeply

affected my life: rhe diethylsrilbesrrol (DES) tragedy It left me, like bell hooks,

hurting and desperate, and I needed a theory to make the pain go away

ln 1966 Dr Arthur Herbst discovered that diethylstilbestrol (DES),the

first synthesized estrogen (1938), could cause a rare clear-cell adenocarcinoma

of the vagina in young girls whose mothers had taken the drug during preg­

nancy As early as 1939 American scientists and physicians started to explore

the use of DES in laboratory and clinical research Dr George Smith, a gyne­

cologist, with his wife, Dr Olive Smith, a biochemisr,-both professors at

Harvard Medical School-were the first promoters of DES as a therapy for

pregnant women The Smiths' two research studies supported their hypoth­

esis that DES taken during pregnancy could decrease the risk of miscarriage

Other scientists criticized their research methodology, and one research group

in Chicago did a large srudy of the effecrs of DES on pregnancy using rigorous

research methods In 1953 the conclusions of the Chicago researchers show­

ing chat DES actually Favors premature labor and has no therapeutic value in

pregnancy were published in the widely read American journal of Obstetrics

and Gynecofogy.l l

lO

Yet the prescribing of DES continued without serious federal drug ad­ministration (FDA) interference until 1975 when estrone, another form of estrogen prescribed at menopause, was linked to increased risk of endometrial

cancer With DES linked ro clear-cell adenocarcinoma of the vagina and es­trone linked to uterine cancer, estrogen h::.td now been solidly identified as possibly cancer causing-in the ':-se of DES as a �ransplacental carci?ogenic and in the case of estrone as a nsk for endomemal cancer By the nme the FDA decided to act in 1975, an estimated 1.5 million young women were DES daughters Abnormalities have also shown up in some of rhe sons of women who were given DES during pregnancy, and DES mothers have a higher rate of breast cancer than women who have not taken the drug

My srory begins in 1955 when, after one miscarriage, I agreed to rake DES co protect my second pregnancy Faithfully T followed my Harvard-trained doctor's orders until my daughter's birth Like most women who rook DES, I was unaware that the Smiths' hypothesis that DES prevented miscarriage was dead wrong My daughter's visit to a gynecologist in 1977 revealed DES ab­normalities which have required dose medical surveillance ever since Her odd-shaped uterus, a common abnormality in DES daughters, made it diffi­cult for a fetus ro adhere ro the lining and to grow In spire of multiple miscar­riages, she had three healthy children, for whom she had longed "T've been pregnane almost nine years counring all rhe miscarriages," she said to me Once I learned of my daughter's iatrogenic disorder, I searched for the truth surrounding this medical betrayal A major discovery was that after the Chicago study was published in 1953, three years before I was given DES, many doctors viewed it as chancy and ineffecrive Because of its Harvard ori­gins, some of the best-trained obstetrician/gynecologists continued ro pre­scribe DES to pregnane women Knowing this medical betrayal, T experienced

a crisis of confidence in medicine that has been validated by the women's health movement's documentation of unnecessary hysterectomies and caesareans, overuse of tranquilizers for women, and sex'Ual abuse of women patients Granted, there are physicians who keep up with research findings and know medicine's weaknesses, which they try to correct on a personal level Yet, as an institution, medicine can be Faulted for irs poor record with women, due, in large part, to irs chauvinistic arrirudes toward women and to treat­ments linked to insufficient theory or simply ignoring theory altogether I felt both guilty and angry as I realized rhat I had taken medication rbar probably added to rhe risk of a second miscarriage and that has left my daughter with a legacy of DES-related health problems Again I e xperienced a theoretical ab­sence not having a way to address my sorrow-but my impending meno­pause was ro change that

lr was 1978 when, steeped in women's health movement rhetoric, 1 firmly rejected the offer of a small dose of esuogen to "get me through menopause."

that I rake a second form of unopposed esrrogen which solid research had

11

had been published in the major medical journals.l2 He went on to reassure

me rhar only women who smoke are at risk and even then only 1 in 1 000

would develop cancer This was rhe end of our relationship and che beginning

of a passionate interest in doing research on menopause

My first question was: "Why is it that a drug known ro be carcinogenic is

being widely prescribed for healthy women who are experiencing a normal

biological event?" It was important for me to try to find answers ro this ques­

tion I wanted to deconstruct myths about menopause, to share new research

findings and debates, to expose medicine's and the pharmaceutical industry's

vested interests in keeping women on estrogen ,and to inform women of alter­

natives to tllis drug Isolated pieces of information would not do this job: 1

needed theories that could organize diverse data and point to a plan of action

Theories became building blocks central to my practice Tasked, "Could this,

in a small way, help to avoid a repetition of the DES disaster?"

Fortunately, at this time, I was studying at Brandeis University where

there was a great interest in applying theory to social problems or issues Classes

with the late Irving Kenneth Zola focused on the sociology of health and

illness and included examination of the relationship between politics and

medicine He concributed heavily tO the theory of medicaliz.ation Zola exam­

ined the ways in which physicians have extended their power through their

role as gatekeepers "by medicalizing much of daily living, by making medicine

and the labels healthy and ill relevanr to an ever increasing part of human

existence." l3

Medicalization can be studied on two levels: concepcual and i nreracrional

Using menopause as example, at the conceptual level, medicalization occurs

when a medical vocabulary or model is used ro defme menopause The view

of menopause as a deficiency disease has continued virtually unchanged in the

medical literature since the 1930s Once it was defined a'> a deficiency condi­

tion, a treatment would be necessary Treatment of choice turned out to be

newly discovered synthesized estrogen On the level of doctor-patient interac­

tion, medicalizacion occurs when individual physicians define or treat meno­

pausal women's concerns as medical problems.l4 A woman may seek out a

physician for an explanation of what to expect at menopause and how to deal

with changes that occur Her questions are posed within a healthy framework

A physician may reframe her concerns as potential symptoms-hot flashes

being a prime example-that will require trearmem and medical surveillance

Medicalization theory is particularly powerful for increasing women's

understanding of how their natural reproductive functions-menses, preg­

nancy, birthing, and menopause-are presented, by medicine, as potential

causes of illness There is hardly a menopausal woman in our society who has

not struggled wid1 the estrogen replacement question even if she feels well and

does not like co take medications l believe chat reframing menopause as a

natural transition in women's lives opens opportunities for them to explore

perspectives on menopause other than medical.l5 Medicaliz.ation theory opened

the door for hisrorians, anthropologists, psychologists, philosophers, spiricual

women, and feminists co replace the deficiency disease myth with positive views of menopause as a normal transition in women's Lives This shift has enhanced healing, for instead of dreading "the change," women, who learn che benefits and lose fear of madness or loss of their sexuality, can usually accept this phase of lifc Some women even see it as a time to reflect on unfin­ ished business they want to resolve before Facing the larger challenge of death.l6

My practice includes transferring knowledge thad acquire in my research

on menopause co professional and lay groups.ll• 18, 19 It was imporrant ro

address osteoporosis and cardiovascular disease being linked to menopause by biomedical researchers and by physicians The kind of research J do can be siruared in Ernest Boyer's typology, described in his report en tided Scholar'Ship Reconsidered: Priorities ofthe p,y;ftssorate, as sd1olarship of integration Or Boyer characterizes this type of scholarship as "making connections across disciplines placing the disciplines in larger context, illuminating clara in a revealing way, often educating specialists too and then interpreting, fitting one's own research or the research of others inro larger intellectual patterns." I re­ view a broad range of literature from The New England journaL of Medicine to Signs and ask these questions: What do these findings or analyses mean? C:m

I interpret this data ro provide a more comprehensive understanding for aca­ demics and the general public? Applying theory to my practice has healed much of the guilt and pain I felt abom my daughter's DES inheritance and the grief it brought her Her optimism and loving reassurance that it was nor my faulr also has helped me see medical berrayal-not my lack of critical infor­ mation on DES-as the ethical problem It has also been healing for me ro alert women char hormones are potent and potentially dangerous drugs that only should be prescribed for serious health problems Today reaching theory and practice is vital for academia, not only for health sciences, but for all

disciplines I predict that it could play an even more essential role in the next millennium

The Millennium and the Academy

In the increasingly technological, corporate, and anti-intellectual climate

we face as the millennium approaches, can theory be sustained as healing? The Face of the 21st century has been decreed, by a wide consensus, to be directed

by laissez-Faire economic theory On rhe one hand, the popular magazine Busi ­

nm \.\'4ek celebrates two currents running through the global economy as we approach the miUennium: the information revolution and the spread of mar­ ker economics Only token notice is being given to potential mass unemploy­ ment and unresr.20 Paradoxically, on che ocher hand, George Soros,21 who has made a fortune in the financial markers, and Jeremy Rifkin,22 socialist author of The End of\flork: The Decline of the Global Labor Force and the Dawn

o f the Post-market Era agree that laissez-faire economics is the greatest threat to our country The threat cakes many forms, but I am concerned here with the threat to theory and practice in universities

In Maine, as elsewhere, the free-market is expanding through the restruc­

vices be far behind? For example, university bookstores nationwide including

chose at Harvard and the University of Pennsylvania System are being bought

These values are already embedded in our everyday language: bortom line,

productivity, downsizing, and small government Privatizing university book

stores would alter what books will be available to academics and students

Choices of books to market would be colored by corporate values that would

likely eliminate new dissertation books or books char criticize corporate power

I have discovered chat theory and practice have healed personal pain and

inspired me to practice in a way thar can heal others Ir is sril1 critical ro under­

stand that teaching theory is not an academic goal that is left unchallenged by

ourside forces Does our profit-oriented society wanr university graduates ro

be thinkers, with knowledge of philosophy, English, sociology, and poUtical

science, or merely skilled workers, who like my father, are expected to follow

orders-nor to ask questions?

Now the university is a safe place where healing theories are caught and

applied These theories provide, as in my experience, systemacic explanations

that point to action They heal and give people a hope to control their lives

better I find it hard ro believe that the millennium will bring us a world char

does nor need theories Universities muse continue to acknowledge their role

of recognizing personal and societal pain leading to illness lf universities are

pressured into giving up rhis mission, ir will lead back co sickness, and there

will be no place to heal

Like the group ar Massachusetts General Hospital watching death arrive

i.n silence, our smdenrs and faculty will experience a themeticaJ absence­

with no way ro address sorrows, like death, thar the millennium will surely

bring

14

References Tolstoy, Leo The Death oflvan llyich and Other Stories New York: Scribner,

1900

2 Ashley, Jo Ann Hospitals, Paternalism, and the Role of the Nurse New York: Teachers College Press, 1976

3 hooks, bell Teaching to Transgress: Education as the Practice of Freedom

New York: Roucledge, 1994

4 Eagleton, Terry The Significance of Theory Cambridge, MA: Blackwell,

1990

5 Coser, Lewis The Functions of Soria/ Conflict New York: The Free Press,

1956

Cambridge, MA: Blackwell, 1994

7 Rich, Adrienne OfV�'oman Born New York: Norton, 1976

MacmiJJan, 1981

9 Kubler-Ross, Elizabeth On Death and Dying New York: MacMillan, 1969

I 0 MacPherson, Kathleen I "Menopause as Disease: The Social Construc­tion of a Metaphor." Advances in Nursing Science 3.2 (1981): 95-113

II Seaman, Barbara, and Gideon Seaman Wonun tmd the Crisis in Sex Hot­ manes New York: Bantam Books, 1977

l2 Ziel, Harry, and William Finkle "Increased Risk of Endometrial Carci­noma Among Users of Conjugated Esuogens.'' New England jounutl of Medi­ cine 293.23 (1975): 1167-1170

13 Zola, Irving Kenneth "Medicine as an Institution of Social Control." Sociology Review 20 ( 1972): 487-504

14 Conrad, Peter and Joseph W Schneider Droia11ce and Medimlization: From Badness to Sickness St Louis, MO: Mosby, 1980

15 MacPherson, Kathleen L "Going ro the Source: Women Reclajm Meno­

pause." Feminist Studies 21.2 (1995): 347-357

16 Van Dyke, Marion Transformation Through Menopause New York: Pranger,

Medicalizacion of Menopause." AnnaLs of the New York Academy of Sciences

592 (1990): 180-184

20 Shepard, Stephen B "Editor's Memo.'' Business wt>ek 18 Nov 1994: 8

21 Soros, George "The Capitalist Threat." Atlantic MonthLy 279.2 (1997): 45-55

22 Rifkin, Jeremy The End ofWork: The DecLine ofthe Global Labor Force and the Dawn of the Post-market Era New York: G.P Putnam's Sons, 1995

15

•

RUSSELL CHAIR SYMPOSIUM

After I had presented my approach to theory and practice I wanted to draw

upon other people ro work together to present a broader perspective of theory

and practice as defined and taught in diverse disciplines I want to thank Pro­

fessors Julie Ellis, Michael Hillard, Rita Kissen, Mark Lapping, julien Murphy

and Susan Vines for generously agreeing to participate in this project

Theory and Practice in Academia Panelists

Julie Ellis Associate Professor of Electrical Engineering

"Educational Theory and Educational Practice"

Michael Hillard Associate Professor Economics

"On Being an 'Organic ImeJlecrual"'

Rita Kissen Associate Professor of Education

"Becoming an Ally: From Theory to Practice"

Mark Lapping

Provost: & Professor of Public Policy & Management

"Theory and Practice in Academia: Two Solitudes"

Julien Murphy

Professor ofPhilosophy

"Theory and Practice: Reflections of a Feminist Philosopher"

Susan Vtnes

Associate Professor of Nursing

"Theory and Practice in Academia: Mind/Body Connection

The Relationship of Chronic Pain and Immunity"

c

Engineering Theory and Educational Practice

by Julie Ellis, Ph.D., associate professor of electrical engineering

When 1 was asked to panicipare in this panel, l agreed in spite of my concerns that

it would be too heady, too intellectual a group, for an engineer to join The attrac­tion, which quickly overrode my concern, was rhe opporruniry to think critically about

my own educational practice in lighr of the theory I know So here I am, more than a little nervous but feeling very welcomed by Kathleen and very inter­ested in hearing my colleagues' thoughtful words abour our theories and our practices I welcome you, too

I thought first about identifYing basic theories of engineering practice In thinking about this, I realized that, despite the large number of scienrific and mathematical theories that engineers use in doing engineering, the profes­sion-the doing of engineering-is really nor a very theoretical enterprise

We use theories, we know theories, but we use them more than we make them

I tried to articulate my own description of engineering: What do engi­neers do? Engineers solve real and particular problems for people How do engineers do what they do? They use ski Us (and theories) they learned in math­ematics and science studies They apply that math and science co those prob­lems using practical common sense, guided by intuition about how things really work Usually working as reams, they engineer by taking multiple passes through a cycle of analysis, design and evaluation There isn't a lor of theoriz­ing, eirher in the process or informing it, because the process is always focused very much on the particular Engineers apply theoretical knowledge, bur not

in a very uniform or theoretical way

Imagine engineers as people with a collection of tools, people confronted with a particular problem to solve with those rools They look into their roo! bag, they pull out and apply the tools that seem to fit the particular problem best, and try to solve ir

We might look imo the bag I am carrying to frnd an example: I can pull our my calculator (uses reverse Polish notation, of course) ro represent my mathematical tools; if I dig around a bit, I can find an apple or two (one a little scrawny, rhe other with a few blemishes, but organic) to represent the scientific tools at hand; right here on my key ring we find a pocketknife (with

an impressive assortment of tools, some of them quite sharp) to represent rhe common sense and understanding of physical reality that every effective engi­neer needs to have; finally we find a notebook and pencils (erasers essential) ro represent rhe observation, documentation and analysis sreps in engineering

•

This curious pile, this motley collection, summarizes much of what engineer­

ing brings to any problem it addresses

Bm there is literature about engineering theory Billy V Koen wrote a tiny

monograph in 1985, Definition of the Engineering Method rr was published

by the American Society for Engineering Education, and it st.ill stands as the

primary articulation of what engineers do when rhey are doing engineering

Koen defines the engineering method as: "the strategy for causing the best change

in a poorly understood or• uncertain situation within the availabLe resources"

The question 1 would raise in this presentation, is whether this definition

of the engineering method, rhis rheo•y of engineering practice, applies to the

practice of engineering education today I would also ask if this definition of

engineering method applies to our practices of higher education I believe it

does Let us e.xamine the definition ro see if the words aptly describe the situ­

ation The definition leaves us with a clear challenge to consider as we engi­

neer our practices in higher education

Do we use strategies?

Of course we do Even if we repeat the patterns we learned, traditional

lectures and testing, we are using strategies that we believe affect student learn­

ing Bur at many schools, and throughout USM, teachers are actively develop­

ing instructional straregies to improve the quality and depth of student learn­

mg

An example of this are the team projects done by students in my Intro­

duction to Engineering class I saw students' lack of.experience wirh rhe engi­

neering process as a problem, and 1 confront rhat problem as an engineer I

found projects that they could do by aslcing K-12 teachers for gizmos they

need These are given to srudenr teams, and they work on them as engineers

do, with prototype reviews, documentation requirements, and limited budget

resources The reams evenrually deliver their solutions, their gizmos, to the

reacher who requested them, who specified them Students follow the engi­

neering process, and I review the larger idea-the meta project-with them to

continually improve it as a solution to the problem of engineering students

needing early experience with engineering practice This is but one example

of the engineering of higher education going on to improve student learning

of professional practice

Do we work within limited available resources?

We certainly do With so many financial and space constraints, faculties

and departments are consistently challenged to do our work, to engineer our

educational solutions, with creativity Bur even more limited than those re­

sources is the resource of time This limitation bears most strongly on every­

one involved in the educational enterprise: students, faculty, staff, departments,

sd1ools, coUeges We must always consider the time required for learning, for

preparation, for processing experiences and make sure that chis most timited

of resources is well-used in the educational experience we share

18

Is ours a poorly understood or uncertain situation?

Amen! Those of U$ teadung in higher education do not as a rule have much background in the theories of learning Yet here we are, practitioners We of­ten work with tools we have developed ourselves, crafted out of our own expe­riences as learners and reachers We, the teachers, are ever learning more about rhe relationships between teaching practice and student learning

Change?

1f higher education is nor about change, then what is it about? Everyone en­gaged in learning is engaged in change At a school like ours, with students and faculty from enormously diverse backgrounds, we can see huge changes occur The primary call and challenge we face as educators is to document that change and ro shepherd ir We must continually engage in the diagnostic act

of reaching to see where each student is, and ro help them in moving further

in and further up coward a full understanding of the material and the skills they have chosen to master

Best

This is the most difficult aspecr of the definicion This is the challenge that we

as professors and students must face If we are to change, how do we cell the best direction? best for whom? best in what system of measure? I leave you with that question As we do our educating, our changing-of ourselves and

of each other-we must ask what direction aie we heading in? And is it the best one, the one we truly choose?

1 9

My "pracrice" as a USM faculty member of

by I I years has evolved and grown I am an

Michael Hillard, economics instructor, a labor economist, associate professor and an activist in the larger Maine commu-

of economics nity I am a dedicated reacher and have

em-phasized mentoring a.� an integral part of

my teaching I have regularly given labor and economics expert commentary,

including: regular, weekly appearances on WCSH-Channel G (1992-1993),

and WMPG (1994- ), "op-ed" pieces in all of Maine's major newspapers, fre­

quent interviews by all media outlets, and testimony co rhe Maine Legislature

(This, perhaps has more tO do with Maine's character as a small media and

legislative "pond" rhan stellar talent on my part.) I n and beyond these forums,

1 have worked with and supported local activist organizations, including: ad­

vocates for the poor and working people such as the stare AFL-CIO and the

Maine Equal Justice project; Maine Businesses for Social Responsibiliry

(MEBSR); and rhe Maine Cenrer for Economic Policy (MECEP) My recent

report "Taking The High Road'' co-authored by David Vail of Bowdoin and

published by MECEP, has been described as a key piece of Maine's ''Good

Jobs Movemenc."l

When I stop and reflect on my career, it seems char my life's work has

exceeded my wildest dreams This symposium has prompted a follow-up ques­

tion: '\vhar were my dreams, and when and where did they start?"

My vision of"theoryand practice'' was formed in my undergraduate years

as a "STPEC"2 major at rhe University of Massachusetts, Amherst The pro­

gram amacred intellectually-oriented activist srudents, focussed on and com­

mitted to "social change." Several wenr on to graduate studies, but most went

straight into the community to become tenants' rights organizers, Congres­

sional aides for politically progressive politicians, or socially responsible pro­

fessionals

"Theory and practice" was the foremost question for STPEC srudenrs

and faculty We were privileged ro study with the best of UMass's large, Left

faculty, including many who were leading scholars itJ their disciplines, such as

Robert Paul Wolff (philosophy), Wj(Jiam Connolly (political theory), Jean

Bethke Elshtain (political pheory), and Bruce Lauric (U.S labor history) The

combination ofimellecrual rigor and debate, camaraderie and political activ­

ism made for heady rimes

Om of this experience, f found myself committed ro three principles whicb

guide my life and work co this day·

• To aspire, not ro the dream of individual success, bur rather to another dream-that of helping to build (in the words of the authors of Habits of the Heart) "a society really worth living in."3

• Society's economic and social structures fundamentally generate the big problems e-xperienced by most people in U.S society-unemployment, pov­erty, alienation in dull and dangerous work, environmental degradation, and rhc like-and that these problems, for rhe most part, defy individual solu­tions

• Agency, pan:icularly the agency of groups organized co act colleccively to change institutional scrucrures, is therefore essential To paraphrase/ quote sev­

eral of Marx's more memorable formulations: "People make their own history,

though not w1der circumstances of their own choosing''; and "The philoso­phers of the world have only interpreted the world in various ways; the point, however, is to change it "4

The STPEC faculty were the source of much of this vision, and also of inspiration and guidance Most had done graduate work in the 1960s and early 1970s, and many were foremost among "New Left" scholars engaged in actively and critically reinterpreting the Left intellectual tradition Moreover, many were great mencors and role models-affirming through their p1¥tctice the vision offered in the classroom From rhem, I could watch and see what it meant co unite theory and practice, and was given the encouragement to imag­ine myselfin their shoes, making che daunting prospect of pursuing a Ph D seem realistic

Bruce Laurie was by far my foremosr mentor A student of David Mont­gomery-one of the "New Labor History's'' leading figures-Law·ie fully em­bodied what I later understood to be an "organic intellectual,'' exemplifying a life lived by the principles l described above

Each Fa11, 75 or so of UMass's brightest activist students would gather in Laurie's undergraduate labor history class Each class was a high-level seminar

on understanding U.S history from the bottom up Classroom exchanges with Laurie highlighted the many historical insights and lessons that would inform our current and future activist practice

lnspired by whar I saw in the classroom, I regularly dropped by during Professor Laurie's offici! hours Laurie's office was walled with floor-ro-ceiling bookshelves packed with old hard-bound books (more than any one person could possibly read in a lifetime, or so I thought), and had rhe odor of big ideas which 1 came co recognize as his ever-changing selection of pipe tobac­cos Inevitably, 1 walked out with a stack of those volumes, as each question I

raised prompted him co pull yet another source from his library

I developed a close relationship with Laurie, deepened rhrough a graduate course, independent study and senior thesis Besides being president of the faculty union, he seemed to know all of rhe progressive trade union activists within 30 miles of Amherst When a "labor and community network" formed

to link these trade unionists with sympathetic faculty and students, 1 quickly found myself thrust into the role of rhe group's chair at Laurie's recommenda-

•

rion As a 20 year-old undergraduate, I was suddenly living the norian of

"practice" that until then was confined to campus activism (which, as we con­

stantly reminded ourselves, was not ''the real world") The "network" held

conferences on "runaway shops," and "organizing in rhe high tech industJy,"

which brought rogether union leaders and activist with the University com­

munity We also joined the picket line for several strikes in the area These

experiences created and deepened my sense of what it was that I wanted to do

with my life

Laurie also gave me the concept of what it meant ro be a truly activist

academic, Antonio Gramsci's "organic intellectual." For Gramsci, organic

imellectuals seek to inspire its [the proletariat] self-confidence as an histori­

cal actor and to provide it with social, cultural, and political leadership.'

U.S labor history abounds with examples of organic intellecruals, from

labor movemem leaders such as Eugene Debs or Mother Jones, to intellectual

activists like Oscar Ameringer (publisher of the Appeal to Reason, a socialist

weekly with a distribution that peaked at 2 million during rhe 1910s) or, in

current rimes, a Staughton Lynd Another key component of this concept is

that of reciprocity between organic intellectuals and workers Intellectuals who

do not regularly interact and learn from che working class are not cruly "or·

ganic." This notion reinforced STPEC scud ems' strong sense of -ami-elitism

and working-class idemification, which Laurie himself encouraged

I joined the USM faculty in 1 986, roughly 5 years later Much of my early

experience here emphasized the "not under circumstances of your own choos­

ing" aspect of Marx's famous adage In a relatively short period of time, I

developed links to many local Maine activists But, while I did find activists, J

did not find a mo11ement For several years, I attempted to organize these activ­

ists together in educational and social gatherings, in rhe hopes that a move­

ment might grow J soon, however, began to discover that my hopes were

unfounded and my efforts misplaced What now?

Well, for one, I slowly broadened my sense of"practice" to include reach­

ing h I did, not only did my teaching "improve' (in the conventional sense),

but my connection with students took on a whole new dimension I think

most students look to their professors for a larger vision and sense of purpose

about life, sometimes consciously and sometimes not I responded in parr by

expanding my efforts to teach labor history and social theory; I also spoke

more openly and passionately about the world around us And when students

can1e to me inspired by my vision of working to build a "society worth living

in," I made a special effort to give them rime and attention, and think con­

sciously about how to best mentor them Where possible, I have helped stu­

dents to get into graduate programs or link them with organizations in the

community where they can begin ro develop and exercise their own sense of

"practice." Of aU the many things I do as a faculty member, this is by far the

most rewarding

A discussion of my reaching would be incomplete without acknow­

ledgement of how much I learn from my srudems They have taught me a

22

•

great deal about Maine's work places One of my delights as a teacher is con­ducting my class as a focus group on all manner of work issues, from output restriction, to contingent labor or union-management relations (usually though not always from the union perspective) Family labor histories have been par­ticularly Fascinating and instructive Respect and interest on my parr has trans­lated into a bountiful, if anecdotal, pictme of work life in Maine

Lessons from my formative experience and education have given my teach­ing practice added meaning One comes fi:om David Montgomery's insight into rhe sudden outburst of militant behavior exhibited by peasant European immigrants during the 1 9 1 Os 6 After a decade or more as a "docile'' work force, they became the core agents in a growing wave of strikes chat began in

1 909 in the steel, apparel and texrile industries (e.g the famous Lawrence

"Bread and Roses" Strike of1912, analyzed well in Ardis Cameron's history of women in the industrial Lawrence?) and peaked at the end ofWorld War I Montgomery finds that these immigrants were socialized by native and Brit­ish craft workers ro resist management authority and to respect and partici­pate in expressions of worker solidarity, which ranged from daily efforts to restrict output to striking The key lesson is that militance emerges from days, weeks, and years of parable and proscription in informal settings, and not from an innate militance nor a simple clash of cultures As a reacher, I can play the role of che craft workers in this story In particular, the lessons of labor history speak for themselves, and embody the 3 principles annunciated above; sharing them with many students year in and year out can contribute to what Raymond Williams has called an oppositional or "emergent culture."8 Having developed a more fruitful and rewarding ''practice" that empha­sizes this broader approach to and philosophy of reaching, am I content? Yes and no I do feel a sense of achievement, ofhaving learned lessons and applied them successfully Yet, I think that, maybe, Pve become roo patient in my approach to producing social change, and that I should be more anxious ro talk about and foment activism among students and colleagues I eagerly look forward to seeing what the future brings to my "practice" here at USM

23